Individual
DR. GRACE MACDOWELL
Active
Individual
DR. GRACE MACDOWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
019217
NY
103G00000X
Clinical Neuropsychologist
Primary
9469748-2501
UT
103TC0700X
Clinical Psychologist
019217
NY
103TC2200X
Clinical Child & Adolescent Psychologist
9469748-2501
UT
103TM1800X
Intellectual & Developmental Disabilities Psychologist
019217
NY
103TM1800X
Intellectual & Developmental Disabilities Psychologist
946748-2501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J300059371
MEDICARE PTAN
NY
Enumeration date
07/08/2011
Last updated
11/05/2020
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